Mitral stenosis during pregnancy poses a substantial risk, both to the mother and foetus. Percutaneous mitral valvuloplasty performed during pregnancy has been associated with an excellent short-term outcome, with reduction of both maternal and foetal complications. We report a case of percutaneous mitral valvuloplasty in a pregnant woman with severe rheumatic mitral stenosis and impending pulmonary oedema. The procedure was performed through a right femoral vein approach, employing the multitrack technique, using 2 balloons (20 and 18 mm). Inadvertently, the procedure was complicated by cardiac tamponade. Despite a stable haemodynamic condition, and absence of echocardiographic signs of chamber collapse, haemodynamic monitoring revealed an equal value for right atrial, left atrial and left ventricular end-diastolic pressure. Immediately, adequate pericardiocentesis was performed and post-procedural echocardiography revealed a mitral valve area of 2.0 cm2, with no mitral regurgitation. Eventually, the pregnancy was continued and ultimately, the patient gave birth to a healthy full-term baby.
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